Risk factors for psychological distress in community-treated epilepsy

• Psychological distress is common in community-treated epilepsy.
• Risk factors are female gender and comorbid medical conditions.
• The use of phenytoin may be a protective factor for psychological distress.
• Epilepsy-related variables are unlikely to explain psychiatric comorbidity.

The study aimed to determine risk factors for psychological distress in a community-treated sample of patients with epilepsy. This study investigated the Tasmanian Epilepsy Register participants. Participants included were as follows: aged 13 years and over, able to complete the individual computer-assisted participant interview, and diagnosed with epilepsy following an epilepsy specialist review of the diagnostic epilepsy interview, which was interpreted using standardized diagnostic guidelines. Psychological distress was assessed with the Kessler-10 questionnaire. Risk factors were grouped into four domains: sociodemographic factors, disease-related factors, psychological factors, and treatment-related factors. High or very high levels of psychological distress were reported by 22% of the participants, with 7.8% having very high distress. The regression model showed that psychological distress was significantly associated with female gender (F = 18.1, p < 0.001), diabetes mellitus (F = 8.7, p = 0.003), intellectual disability (F = 7.1, p = 0.06), and not receiving phenytoin (F = 5.1, p = 0.02). While the model was significant (F = 5.78, p < 0.001), only 11% of the variance of the K-10 score was explained by these factors (adjusted R-squared = 0.11). This study identifies female gender and comorbid medical conditions as risk factors for psychological distress and the use of phenytoin as a protective factor. The few factors identified and the limited variance explained suggest that a focus on epilepsy-related variables is unlikely to explain key influences underlying psychiatric comorbidity in patients with epilepsy.